Sanitation infrastructure has been found to be essential for human health and flourishing, but these services are not universally available in the U.S.. Rural communities lack many of the local resources and support structures that sustain sanitation systems in urban contexts and consequently face challenges in competing for funding and technical support against better-resources communities. This study seeks to examine how state and county-level policies combined with poor environmental conditions have led to prolonged sanitation failures, public health hazards, and financial burdens in primarily black communities in the southern United States. Specifically, we combine interviews, survey data, and water quality sampling from Lowndes County, Alabama to capture interactions between the built environment and social systems. Anecdotal evidence reveals that increased rainfall, heat, and high groundwater levels have contributed to more frequent sanitation failures. Focus groups and surveys also expose the extent to which residents have had to adapt to failing sanitation systems and the substantial behavioral and lifestyle changes they’ve made. We find that combining qualitative and quantitative community-engaged research methods provide a greater depth of understanding of the causes and effects of these issues. By incorporating community knowledge, decision makers can develop solutions that better suit residents’ unique needs, thus promoting a more equitable decision making process.
